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Home My WebLink About05-02-14 (2) 1 J REV-1500EX(06-05) 15056051058 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes w County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg,PA 1712E-0691 - RESIDENT DECEDENT 21 13 0878 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 08/06/2013 12/19/1918 Decedent's Last Name Suffix Decedent's First Name MI Freeland Agnes L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW LwD 1.Original Return C—,:� 2.Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 4.Limited Estate C:7 4a. Future Interest Compromise(date of C:D s Federal Estate Tax Return Required death after 12-12-82) (J) 6. Decedent Died Testate = 7. Decedent Maintained a Living Trust _. 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) (�..! 9.Litigation Proceeds Received = 10.Spousal Poverty Credit(date of death 11, Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Esther Crawford (717)648-8661 Firm Name(if Applicable) --. - - -..-. .............. REGISTER OF WILLS USE ONLY l First line of address O ; RIO ( CID CD 310 E Marble St M Ri 2 n —C Cl'1 �I Second tine of address i r— Rl .i rt m s fV ':?0 0 City or Post Office State ZIP Code -ATE Mechanicsburg PA 17055 N m D 1 C Correspondent's e-mail address: ECraw702O9@aol.com Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI U E OF ERSO E NSIBLE FO Fl G RET N DATE 04/23/13 ADDRESS 310E arble St, Mechanicsburg 17055 G A R EEN�7TIVE 114 DATE G02RQ I,i xo J i 1lPrt D, L7ou Q2a4c Pc 04/23/13 ADD SS 701 N 2nd St, Harrisburg PA 17102 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 V J15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: Agnes L Freeland 1. Real estate(Schedule A). .. .. ........ . .. ... .. ............ .... ... ... . 1. 2. Stocks and Bonds(Schedule B) . ... _ . ...... ....... ..... ...... . .. .... . 2. 311,213.56 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . ... . 3. 4. Mortgages&Notes Receivable(Schedule D).. .... . .. ... .. .. ... ... . .... .. 4. ' 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E) .. .._.. 5. 23,508.74 6. Jointly Owned Property(Schedule F) = Separate Billing Requested ... .... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C.D Separate Billing Requested.. ... .. . 7. 8. Total Gross Assets(total Lines 1-7)... .. ... ....... ... .. ..... ... .. ... ... 8. 334,722.30 9. Funeral Expenses&Administrative Costs(Schedule H).. .. ... .. . .... _. ... . 9. 10,452.50 10. Debts of Decedent, Mortgage Liabilities,&Liens(Schedule 1). .. ... ... .. . .... 10. 7,299.25 11. Total Deductions(total Lines 9& 10).. . .... .. .. ... .. . .... ... ... . 11. : 17,751.75 12. Net Value of Estate(Line 8 minus Line 11) . .. ... .. .. ... .. ... .. ... .. . .... 12. 316,970.55 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which -_........._,......_m»._..._.__._....._.___...___..._„...._.._.,.,. an election to tax has not been made(Schedule J) . ...... .. ..... ..... ..... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . ........ .. ..... . .. ..... 14. 316,970.55 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES ��...�___._..,..,,._...»..__.... ._ 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 -- -- - �- , (a)(1.2)X.0- 0.00 : 15, 0.00 16. Amount of Line 14 taxable '. at lineal rate X.0 45 0.00 16. 0.00 ____...._._..._...._--__..___..._:_�.�._._...__.. 17. Amount of Line 14 taxable at sibling rate X.12 0.00 t7 0.00 . ,......._. ----- ---- 18. Amount of Line 14 taxable 31697055 47 545.58 at collateral rate X.15 316,970.55 18 19. TAX DUE .. ...... .. . . ....... ... ... 19.: 47 545.58 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 13 0878 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Agnes L Freeland STREETADDRESS 100 Mt Allen Drive Room 63 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2 Line 19) (1) 47,545.58 2. Credits/Payments A.Spousal Poverty Credit B.Prior Payments 44,347.93 C.Discount 2,334.10 Total Credits(A+B+C) (2) 46,682.03 3. InteresVPenalty if applicable D.Interest E.Penalty Total Interest/Penalty,(D+E) (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 663.55 A.Enter the interest on the tax due. (5A) B.Enter the total of Line 5+5A.This is the BALANCE DUE. (5B) 863.55 Make Check Payable to: REGISTER OF WILLS,AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... ❑ ❑1c b. retain the right to designate who shall use the property transferred or its income;............................................ ❑ c. retain a reversionary interest:or.......................................................................................................................... ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 3. Did decedent own an"in trust for"or payable upon death bank account or security at his or her death?.............. ❑ 4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ❑ ❑K IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three(3)percent[72 P.S.§9116(a)(1.1)(i)] For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero(0) percent [72 P.S. §9116(a)(1.1)(ii)).The statute does not exam ot a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is zero(0)percent[72 P.S.§9116(a)(1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half(4.5)percent, except as noted in 72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve(12)percent(72 P.S.§9116(a)(1.3)].A sibling is defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1503 EX*(6-98 SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Freeland,Agnes L 21-13-0878 All property jolntlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t American Funds(acct#64688648)-mutual funds 311,213.56 TOTAL(Also enter on line 2,Recapitulation) $, 311,213.56 (If more space is needed,Insert additional sheets of the same size) REV-1508 EX.(6-e8) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Freeland, Agnes L 21-13-0878 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 01 Personal Checking Account 5,636.74 02 .Deposit In-Transit 15,000.00 03 PA Income Tax Refund receivable 72.00 04 Long Term Care Benefits receivable 2,800.00 TOTAL(Also enter online 5,Recapitulation) $ 23,508.74 (if more space is needed,Insert additional sheets of the same size) REV-1511 EXt(12-99) & SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & ' INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Freeland, Agnes L. 21-13-0878 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Funeral&Memorial Services 9,176.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions - - -- Name of Personal Representative(s) - - - Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City ,Slate Zip Years)Commission Paid: 2. Attorney Fees 3. Family Exemption:(If decedent's address Is not the some as claimant's,attach explanation) Claimant Street Address .. . .. . CRY State •-Zip Relationship of Claimant to Decedent 4. Probate Fees 468.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 804.00 7. Bank Fees 4.00 TOTAL(Also enter on line 9,Recapitulation) $ 10,452.50 (If more space is needed,insen additional sheets of the same size) REV-1512 EX.(12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Freeland, Agnes L 21-13-0878 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death,Including unmimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Messiah Village 7,159.91 2., Alert Pharmacy 19.34 3. Verizon 24.93 4. Allianz 95.07 TOTAL(Also enter online 10,Recapitulation) $ 7,299.25 (If more space is needed,Insert additional sheets of the same size) REV-1513 EX+(900) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Freeland, Agnes L 21-13-0878 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS include outright spousal distributions;and transfers under Sec.9116(a)(1.2)) 1 Mary Vallozzi,790 N Main St,Apt J18,Greensburg,PA 15601 Niece 1,000.00 2. Messiah Village, 100 Mt Allen Dr,Mechanicsburg,PA 17055 None 5,000.00 3. Esther Crawford,310 E Marble St,Mechanicsburg,PA 17055 None 310,970.55 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET S 0.00 (If more space is needed,insert additional sheets of the same size) -7 .... Cm LAST WILL AND TESTAMENT of _ AGNES L. FREELAND I, AGNES L. FREELAND, of 343 Messiah Circle, Messiah Village,Ivlechanicsburg, Cumberland County, Pennsylvania, revoke any and all prior Wills and Codicils and declare this to be my Will. ITEM 1 - I am a widow and have no children. My closest relatives are a brother, nephews and nieces. ITEM 2 - I give One Thousand Dollars ($1,000.00) to my niece MARY VALLOZZI ITEM 3 - I give Five Thousand Dollars ($5,000.00)to Messiah Village, Mechanicsburg, Pennsylvania,to be used in whatever way they decide. ITEM 4 - I give the rest, residue and remainder of my estate to my good friend ESTHER CRAWFORD, Mechanicsburg, Cumberland County, Pennsylvania. ITEM 5 - In the event ESTHER CRAWFORD predeceases me,I give the rest, residue and remainder of my estate to her husband, GENE CRAWFORD, if he is married to her at the time of her death. Item 6 - In addition to the powers conferred by the common law, statute or any other provisions hererby,my Personal Representatives are hereby empowered as follows: (a) To sell at public or private sale, to exchange,to lease, to pledge, to mortgage, to transfer,to convert,or otherwise dispose of, or grant options with respect to, any and all property, real,personal or mixed at any time forming a part of my probate estate, in such manner, at such time or times, for such purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circumstances; (b) To assent to,join in, and vote in favor of any merger,reorganization, voting trust, plan, lease, mortgage,consolidation, exchange,foreclosure of any corporation or other investment in which the probate estate may hold stock, bonds, investments, or an interest; (c) To vote in person or by general or limited proxy with respect to any share of stock or other investment held by the probate estate; (d) To make distribution in division of the probate estate in cash, in kind, or partly in both; (e) To distribute articles to a minor or to her or his guardian or to any person taking care of the minors to hold for them in or within the limits authorized by statute or rule of law; (f) To compromise any claim or controversy; (g) To apportion between principal and income any receipts and disbursements and to ascertain income and principal in accordance with the statutes and rules of law of the Commonwealth of Pennsylvania. A (h) To keep property in the name of a nominee with or without disclosure of any fiduciary relationship; (i) To employ attorneys,auditors, depositories and proxies with or without discretionary power; (j) To make, execute, acknowledge and deliver any and all instruments which may be deemed advisable or necessary to carry out any of the powers herein granted or provided by law; (k) To invest and reinvest the principal of the probate estate,together with any accumulated income thereon whenever such accumulation has been permitted by the terms here, in all forms of property,real,personal or mixed, including but not limited to stocks,bonds, common trust funds, mortgage, investment funds, insurance policies and annuities without being limited by any statute or rule of law concerning investments by fiduciaries; (1) To carry out the terms of any agreement I may have entered into to sell all or any part of any property or any interest I may own in any business at the time of my death; (m) To exercise any law-given option to treat administrative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income; (n) To disclaim inheritances and interests in property; (o) To apportion tax basis among bequests in accordance with the Internal Revenue Code, applicable regulations and other state or federal laws. ITEM 7 - I nominate and appoint ESTHER CRAWFORD, as the Executrix of this, my Last Will and Testament. If my Executrix predeceases me or is unable to serve as my Executrix,then I nominate and appoint her husband, GENE CRAWFORD, Executor,if he is married to her at the time of her death. In the event ESTHER CRAWFORD and her husband, GENE CRAWFORD, predecease me, or if ESTHER CRAWFORD predeceases me and her husband GENE CRAWFORD, is not married to her at the time of her death, I appoint my attorney, HERBERT G. RUPP,JR., to be the Executor. 1 ITEM 8 - For the convenience of my Personal Representatives, I note this Will has been prepared by my attorney Herbert G. Rupp,Jr. Executed 2008. U AGNE L.FREELAND Signed, sealed, published and declared by the above named Testatrix, AGNES L. FREELAND, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. Address �J f Address /i j Commonwealth of Pennsylvania SS. County of Dauphin We, AGNES L. FREELAND, and A. `T yv; k and }�Z �_Y'(, I( C, 'j} h t..y V, ,the Testatrix and the witnesses, respectively,whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly(or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. .13e"stafnx` c' Witness Sworn to or affirmed and acknowledged before me by the above-named Testatrix and witnesses this �/ day of 2008/. . Notary Public My Commission Expires: (SEAL) NOVM an *M IMI/N W=WU OK WAMN MA" 1*F, -on0l now$t.f�